would probably rupture through the wall of adhesions that nature has industriously built around it during the last ten days, and give him a general, instead of a local, peritonitis. Moreover, the appendix has probably done its worst in rupturing and in forming this abscess. It is like a bursted firecracker that has set a house on fire. It is not essential to rescue the firecracker from the burning building. Of all appendices thus left in, about eight out of ten cases give no further trouble. In the event it should, it can be easily removed as an interval operation in the absence of fever and pus with practically no risk.

All cases of appendicitis should be operated on as early as possible. Murphy says whenever an appendix is allowed to perforate before operation that the case up to that time has been maltreated. The greatest mistake we make in acute abdominal cases is purgation. It is distinctly harmful, because it loosens newly formed adhesions by peristaltic action and allows an escape of the infected material. Every case that comes into the hospital with perforation has a history of purgation. Every text-book in the world advises. against purgatives in appendicitis, and I regret to say many men in our profession are constantly making this mistake. If the patient is not seen until the third or fourth day with appendicitis, which is a notoriously bad time to operate, requiring the superlative efforts of the most skilled surgeon to thus rescue the patient, it may be advisable, by the starvation and non-purgation method of Ochsner, to allow the case to wall itself off into an abscess just as this one has done. Nobody, however, by this treatment can guarantee it will go successfully to a safe operation on the tenth, twelfth, or fourteenth day; and still, ordinarily speaking, it is probably better in a majority of cases than indiscriminate operation at the most inopportune and dangerous period. If by good fortune the patient escapes peritonitis and abscess and undergoes resolution, with or without, or in spite of treatment, then the operation should be done before another attack.

Editorial.

WHY WE SHOULD BUY GOODS MADE IN U. S. A.

(The following letter to the editor of Collier's Weekly with editorial remarks appeared in the Jan. 16, 1915, issue of that publication, and has our most hearty endorsement.-Ed. S. P.)

"Dear Mr. Editor: Collier's is doing commendable work in urging the American people to buy goods 'Made in U. S. A.' The future welfare of our country and the prosperity of our people depend very largely upon the success of the "Made in U. S. A." propaganda.

"Many publications are encouraging the American people to buy American-made goods without giving specific reasons why they should do so. Dont' you think that the movement will gain greater impetus and accomplish more for the manufacturer, as well as the consumer, if substantiatial reasons why' arguments are presented?

"You are a student of national problems, while we manufacturers, who are engaged in import and export commerce, are deply involved in the problems of manufacturing and marketing merchandise. I believe we should work together; therefore I offer you some facts based on my personal experiences in European countries.

"With my associates, I am engaged in the manufacture of an article which is consumed in every part of the civilized globe. Our business orignated thirty-three years ago and in its entirety is owned by American people. We maintain headquarters, offices and warerooms on this continent, also factories in many foreign countries, including France, Germany, Austria and Spain.

"Americans and Britishers always have traveled extensively. Years ago they began to demand our product when abroad, and to satisfy this demand we attempted export shipment. Our American factories were then large enough to supply the universal demand, but when entering the foreign field we found it impossible profitably to clear our merchandise in many ports. Germany, Austria, France and Spain demanded prohibitive duties. This left us the choice of discontinuing our export business or yielding to the demands of the foreigner, which in substance were: 'If you want to do business in our country, you must pay rents to our landlords, use our raw materials and employ our labor.' We were practically forced to equip and maintain factories in the above mentioned places.

"Without any desire to criticise the spirit which prompted the demands of these countries, I will say that the disadvantage to us has been very great. But we have had an even greater disadventage to contend with, to illustrate which I will relate a part of my experience in Germany:

"In Berlin I advertised for a highly trained city representative. Many responded and I interviewed and discharged all but two, who were requested to report to me the following Friday. When one man reported he immediately asked for his references, stating that he did not want the position. Upon being questioned he replied about as follows:

"I have spent the last two days interviewing the trade and investigating your product. It is American owned and the retailers will not push a foreign-owned product. Their customers prefer and demand articles made only in the Fatherland. I see no future for me with your company.'

"The other man accepted the position, but resigned shortly afterwards. He also found that German people demand goods made in the Fatherland, by concerns owned in the Fatherland.

"Germany has asked us to buy her goods and we have cheerfully complied with the request. American dollars have made German manufacturers wealthy, yet the German people refuse to buy our goods.

No

"Germany has become a strong nation because her people stick together and work together. They patronize home industry. where else in the world is the term "home industry" understood and appreciated as it is in Germany.

"Many foreign-made cosmetics, proprietary medicines, textiles, toys and other articles are sold in America in competition with American-made and owned products that are really as good, and in some cases vastly better, at no higher price than the imported goods. Millions of dollars are expended by American people for French soaps, toilet articles, silks, millinery, gowns, etc. One great Paris firm does a tremendous toilet soap business in America, despite the fact that our domestic manufacturers produce superior soaps at less cost.

"Within the last few years foreign manufacturers have established distributing points and even factories on American soil, but they are foreign-owned.

"When we confine our demand for articles we eat, wear or use to those made in America by American capital and labor, then will our American enterprises grow in leaps and bounds, and since many foreign-owned articles are made in this country, or sold through domestic agents, each article should be carefully scrutinized and its ownership determined so that those which are foreign-owned can be avoided whenever similar products of home manufacture are obtainable.

"The German-American press and the agents of the Kaiser are vigorously protesting against the lack of American sympathy for their

cause, but perhaps its does not occur to them that our spirit of fair play, even our sense of humor, does not permit us to approve of or enjoy what may be styled a travesty on reciprocity-a burlesque on equity!

"Foreign governments have done much to assure tariff protection of their industries, but in some countries it has rested with the people as individuals to do far more than it is possible to accomplish by stringent legislation. True patriotism means 100 per cent protection.

"I am withholding the name of the company in which I am interested for the reason that I am not seeking free publicity for its product."

"(The writer of the above letter is Mr. Jordan W. Lambert, of of the Lambert Pharmacal Company, St. Louis. manufacturers of Listerine. We give this information because the letter is fair, interesting and informative, and we are glad to give the writer of it whatever benefit may accrue from our doing so.-E. C. P.)

"We like the above letter because it gives real facts, based upon real experience. Americans are a tolerant, easy-going people in business matters, largely because prosperity generally has come to us without great effort. Our commerce of the future must be based upon more conscious effort, more skill in marketing and more patriotic support of our own industries, because more than ever we are going to face the effort, skill and commercial patriotism of foreign nations.

"Foreign commerce is crippled now, but when the war is over it will meet us with redoubled effort in every market of the world, particularly our own. Therefore it behooves us to se that the goods we consume, wherever possible, are "MADE IN THE UNITED STATES, AND THAT THEY BEAR THE NAME AND TRADEMARK OF THE MANUFACTURER AS WELL AS THE NATIONAL TRADE-MARK, 'MADE IN U. S. A.”

"C. E. PATTERSON, Vice-President and General Manager
"P. F. Collier & Son, Inc."

QUALIFIED ANESTHETISTS:-The following resolution was recently passed by the New York Society of Anesthetists: "Resolved, That it is the sense of the New York Society of Anesthetists that the administration of a general anesthetic by anyone other than a regularly qualified practitioner of medicine be not allowed; and that the county and state societies be asked to press legislation to this end and, further, that this action by the New York Society of Anesthetists be published in all the medical journals of the state. (A most excellent measure and should be adopted by every state.-Ed. S. P.)

THE AMBULANCE CONSTRUCTION COMMISSION

This is the first great war in which field motor ambulances have been extensively used. It was inevitable that many defects should be found in existing types, and in various quarters experts began to ask whether something could not be done to standardize the patterns and to improve the type. At the instance of Mr. Henry S. Wellcome, the founder of the Wellcome Bureau of Scientific Research, a Commission has been formed, and the names of members show at once that the matter is regarded as of first importance by those most intimately connected with the welfare of the wounded soldier.

Sir Frederick Treves, whose long experience and distinguished service specially fit him for the task, has consented to be the Chairman. The Admiralty is represented by the Director-General of the Medical Department, R. N., while the Quartermaster-General to the Forces and the Acting Director-General, Army Medical Service, represent the War Office. The Birtish Red Cross Society is, of course, represented by Sir Frederick Treves, and the St. John Ambulance Association by Sir Claude Macdonald and Sir John Furley. The remaining members are all experts. This Commission will first and foremost act as a judging committee for the award of prizes of the value of £2,000 provided by the Wellcome Bureau of Scientific Research. These prizes are offered for the best designs of an ambulance body which shall fit a standard pattern motor chassis for field motor ambulances. The last day for the receipt of competing designs is June 30, 1915. It is hoped that the competition will bring in a number of ingenious designs, from which the ideal field ambulance body will be evolved.

It may be asked why the competition is restricted to designs for a body and not for the complete ambulance, including a chassis. The reason is that a chassis takes much longer to build than a body, and that, when war breaks out, it is impossible to get at short notice anything like a sufficient number of any one type of chassis. On the other hand, a standardized body to fit any chassis of approved dimensions can be constructed in numbers at comparatively short notice. And a perfected body is badly wanted to ensure complete comfort for the wounded.

It is hoped that the information obtained by the competition, and in other ways, will be published in some permanent form, available for future reference. Probably in addition to one design of special excellence, there will be submitted various ingenious suggestions which may be incorporated in the pattern design approved by the Commission. For these, a portion of the prize money has been set apart. The first prize is of one thousand pounds, the second of five hundred,